HomeMy WebLinkAboutWORK ACCEPTANCE FORM ROCKY MOUNTAIN ELECTRIC - 23-00456 - MMH Behavioral Health TI - RemodelContractor Work Acceptance Form
Business Name:*
Contact Name:*
Mailing Address
Email:*Phone:*
Mobile:
Discipline:*License #:*Expiration Date:*Value of Work:
Permit Number:*
Project Name:*
Project Address:*
By signing, I acknowledge that I am the indicated contractor for the above mentioned Permit/Project.
Signature Date
Contractor/Subcontractor
Rocky Mountain Electric
Lee Boren
City
Idaho Falls
State / Province / Region
Idaho
Postal / Zip Code
83401
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
6698 25th E, Idaho Falls, ID 83401
Address Line 2
rmeidanet@gmail.com 2085896826
Electrical PWC-C-14992 9/30/2023 19,739.00$
Permit Information
Please enter in the following format: 00-00000
23-00456 MMH Behavioral Health TI
37 S 2ND STREET EAST, REXBURG, IDAHO
83440
Acceptance
Sign 8/10/2023